Individual provider Active NPI

Elisa D Canaca, RPH

  • Pharmacist
  • Linden, NJ
National Provider Identifier
1154599249
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02728900 Issued in NJ
Practice address
637 W Edgar Rd
Linden, NJ 07036-3203
Phone
(908) 523-1663
Fax
(908) 523-0891
NPI assigned
Feb 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02728900 NJ Primary

Addresses

Primary practice location

637 W Edgar Rd
Linden, NJ 07036-3203

Mailing address

637 W Edgar Rd
Linden, NJ 07036-3203
Phone (908) 523-1663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI02728900NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rockaway Shoprite Associates Inc Past Accepting new patients
Rockaway Shoprite Associates Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1154599249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 W EDGAR RD",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070363203",
            "telephone_number": "908-523-1663",
            "fax_number": "908-523-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 W EDGAR RD",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070363203",
            "telephone_number": "908-523-1663",
            "fax_number": "908-523-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANACA",
        "first_name": "ELISA",
        "middle_name": "D",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02728900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.